About Dr. Angela Mailis

Dr. Angela Mailis obtained her medical degree from the Medical School of Kapodistriakon University of Athens Greece Summa Cum Laude; became a Fellow of the Royal College of Physicians of Canada with specialization in Physical Medicine (1982); and holds a Master’s degree from the Institute of Medical Science, University of Toronto (1988). She rose to the rank of Full Professor at the Faculty of Medicine, University of Toronto (2005) and has practiced exclusively in the area of Chronic Pain for the past 43 years. She founded and directed the Comprehensive Pain Program of the Toronto Western Hospital/University Health Network for 33 years (1982-2015). Subsequently she became the founder and director of the Pain and Wellness Centre in Vaughan Ontario (2014-present), the only academic community-based pain clinic, funded by the Ontario Ministry of Health.

Dr. Angela Mailis in her office at the Pain and Wellness Centre
Career Highlights

The Multifaceted Career of Dr. Angela Mailis

Dr. Mailis’s career is multifaceted. She is pain clinician, scientist, educator, published author, patient advocate, advisor to policy makers, medicolegal expert, and mentor.

As a clinician “she diagnoses before she treats pain” and has seen over 30,000 patients in her lifetime.

As a scientist she asks questions, devises methods to provide answers, and has published more than 140 papers in scientific journals.

As an educator, she has trained numerous students and international trainees and lectured around the world; as well as, has served extensively the public via lectures and writings in popular media.

As a mentor she continues to provide inspiration and support to multiple students and trainees and in particular, women and immigrants in science and medicine.

As a patient advocate, she has chaired a not-for-profit organization (ACTION Ontario 2005-2022), canvassing Queen’s Park to educate members of the parliament and provincial health ministers on chronic pain.

As advisor to policy makers, she has faithfully provided assistance to the Ontario Ministry of Health since 2009 in various matters relating to chronic pain and has been instrumental in shaping management of chronic pain in the province of Ontario.

As a highly respected medicolegal expert, she has provided more than 3000 medicolegal assessments for both plaintiffs and defense, (individuals, organizations, hospitals, airlines etc) and has testified in several courts in Ontario and occasionally in the USA.

Her Popular Science book BEYOND PAIN forwarded by Dr. Oliver Sacks was published in 2003 and her second book (Smart, Successful and Abused) was published in 2019, both in Canada and USA.

Publications Timeline

Important Scientific Publications

Patient Presentations in a Community Pain Clinic after COVID-19 Infection or Vaccination: A Case-Series Approach

Information collected in this study will add to the body of COVID-19-related literature and assist particularly community practitioners in recognizing and managing these conditions.

Long Term Outcomes of Chronic Pain Patients attending a publicly funded community-based Interdisciplinary Pain Program

The primary objective of this retrospective study (based on practice-based audit) was to determine the effectiveness of a patient-centered, comprehensive and intense interdisciplinary pain management program in a publicly funded community-based pain clinic in the Greater Toronto Area.

A retrospective look at a community-based patient-centered model of care for chronic pain

A retrospective look at a community-based patient-centered model of care for chronic pain, Canadian Journal of Pain. The aim of this study was to describe the development and implementation of a publicly funded and patient-centered model of care in the community.

  • Mailis, A.; Kupferstein, N.; Assimakopoulos, D.; Mailis, A.C.; Sutton, S.; Lakha, S.F. Patient Presentations in a Community Pain Clinic after COVID-19 Infection or Vaccination: A Case-Series Approach. Clin. Pract. 2023, 13, 1593–1602. https://doi.org/10.3390/ clinpract13060139
  • Mailis A, Deshpande A, Lakha SF. Long Term Outcomes of Chronic Pain Patients attending a publicly funded community-based Interdisciplinary Pain Program in the Greater Toronto Area: results of a practice-based audit. Journal of Patient-Reported Outcomes (2022) 6:44 https://doi.org/10.1186/s41687-022-00452-z
  • Lakha SF, Hapidou E, Robinson J, & Mailis A. Comparison of Motor Vehicle Accident (MVA) survivors and non-MVA pain patients attending an interdisciplinary pain management program. Psychological Injury and Law, published on line January 8, 2022; https://doi.org/10.1007/s12207-021-09440-y.
  • Lakha SF, Assimakopoulos D, Mailis A. Comparison of Older and Younger Patients referred to a non-interventional community pain clinic in the Greater Toronto Area (GTA). Pain Ther (2022) https://doi.org/10.1007/s40122-022-00435-4.
  • S. Fatima Lakha . Amol Deshpande . Demetry Assimakopoulos . Angela Mailis. Demographics, Pain Characteristics and Diagnostic Classification Profile of Chronic Non-Cancer Pain Patients Attending a Canadian University-Affiliated Community Pain Clinic. Pain Ther, Published on line August 19, 2021, https://doi.org/10.1007/s40122-021-00301-9
  • Mailis, A., Tepperman, P.S. & Hapidou, E.G. Chronic Pain: Evolution of Clinical Definitions and Implications for Practice. Psychol. Inj. and Law 13, 412–426 (2020). https://doi.org/10.1007/s12207-020-09391-w
  • Mailis A, & Lakha S. Fatima From (Ontario Ministry of Health and Long-Term Care) policy to implementation: A retrospective look at a community-based patient-centered model of care for chronic pain, Canadian Journal of Pain, 2019, 3:1, 114- 125.
  • Mailis Angela, Nicholson Keith. Non Dermatomal Somatosensory Deficits (NDSDs) and pain: State of the Art review. Psychological Injury and Law. DOI 10.1007/s12207-017-9300-z, 2017:10(4), 313-329
  • Mailis A, Zoheiry N, Alkokani M, Lakha SF, Deshpande A, Spivak K. Non Dermatomal Somatosensory Deficits (NDSDs) in Chronic Pain Litigants. Chron Pain Manag 2017:J101:1-7.
  • Mailis-Gagnon Angela, Lakha S. Fatima, Allen Matti D., Deshpande Amol, Harden R. Norman. Characteristics of Complex Regional Pain Syndrome in patients referred to a tertiary pain clinic by community physicians, assessed by the Budapest Clinical Diagnostic Criteria. Pain Medicine, 2014;15:1965-1974.

  • Mailis Gagnon A, Taenzer P. Evidence based guideline for neuropathic pain interventional treatments: spinal cord stimulation, IV infusions, epidural injections and nerve blocks. Pain Res Manage 2012;17(3):150-158.

  • Mailis-Gagnon A, Lakha S.Fatima, Furlan A, Nicholson K, Sabatowski R, Schroeder B. Systematic Review of the quality of studies on the effects of opioids on driving and cognitive/psychomotor performance. Clin J Pain 2012;28:542-555.

  • Mailis-Gagnon A, Nicholson K, Chaparro L. Analysis of complaints to a tertiary care pain clinic over a nine-year period. Pain Res Manage 2010, Volume 15 Issue 1: 17- 23.

  • Mailis-Gagnon A, Lakha S.Fatima, Furlan A, Nicholson K, Sabatowski R, Schroeder B. Systematic Review of the quality of studies on the effects of opioids on driving and cognitive/psychomotor performance. Clin J Pain 2012;28:542-555.

  • Mailis-Gagnon A, Nicholson K, Blumberger D, Zurowski M. Characteristics and Period Prevalence of Self-induced Disorder in Patients Referred to a Pain Clinic With the Diagnosis of Complex Regional Pain Syndrome. Clin J Pain 2008;24:176–185.

  • Mailis-Gagnon A, Yegneswaran B, Lakha SF, Nicholson K, Steiman AJ, Ng D, Papagapiou M, Umana M, Cohodarevic T, Zurowski M. Pain characteristics and demographics of patients attending a university affiliated pain clinic in Toronto, Canada. Pain Res Manage 2007, 12(2):93-99.

  • Mailis-Gagnon A, Yegneswaran B, Lakha SF, Nicholson K, Steiman AJ, Ng D, Papagapiou M, Umana M, Cohodarevic T, Zurowski M. Ethnocultural and Gender Characteristics of Patients Attending a Tertiary Care Pain Clinic in Toronto, Canada. Pain Res Manage 2007, 12(2):100-106.

  • Kapetanos A, Furlan A, Mailis-Gagnon A. Characteristics and associated features of persistent post-sympathectomy pain. Clin J Pain 19:192-199, 2003.

  • Mailis-Gagnon A, Giannoylis I, Downar J, Kwan CL, Mikulis DJ, Crawley AP, Nicholson K, Davis KD. Altered central somatosensory processing in chronic pain patients with “hysterical” anesthesia. Neurology 60:1501-1507, 2003.

  • Sa DS, Mailis-Gagnon A, Nicholson K, Lang AE. Post-traumatic Painful Torticollis.

  • Movement Disorders. Mov Disord 8(12): 1482-1489, 2003.

  • Mailis A, Bennett GJ. Dissociation between cutaneous and deep sensibility in central post-stroke pain (CPSP). Pain 98: 331-334, 2002.

  • Mailis A, Papagapiou M, Umana M, Nowak J, Cohodarevic T, Nicholson K. Unexplainable non-dermatomal somatosensory deficits in patients with chronic non malignant pain in the context of litigation/compensation: A role for involvement of central factors? J Rheumatol 28:1385-1393, 2001.

  • Mailis A, Umana M, Feindel C. Anterior intercostal nerve damage after CABG-ITA surgery. Ann Thor Surg 69:1455-8, 2000.

  • Furlan A, Mailis A, Papagapiou M. Are we paying a high price for surgical sympathectomy? A systematic literature review of late complications. J Pain, 1;4:245-257, 2000.

  •  Cohodarevic T, Mailis A, Montanera W. Syringomyelia: Pain, Somatosensory abnormalities and Neuroimaging. J Pain 1;1:54-66, 2000.

  • Mailis A, Plapler P, Ashby P, Shoichet R, Roe S. I. Effect of intravenous sodium amytal on cutaneous limb temperatures and sympathetic skin responses in normal subjects and pain patients with and without Complex Regional Pain Syndromes (Type I and II). I. Pain 70:59-68, 1997a.

  • Mailis A, Amani N, Umana M, Basur R, Roe S. II. Effects of intravenous sodium amytal on cutaneous sensory abnormalities, spontaneous pain and algometric pain pressure thresholds in neuropathic pain patients: a placebo-controlled study. II. Pain 70:69-81, 1997b.

  • Mailis A. Targeted Self-injurious behaviour in humans with neuropathic pain: A counterpart of animal autotomy? Pain 64:569-578, 1996.

  • Mailis A, Papagapiou M, Vanderlinden RG, Campbell V, Taylor A. Thoracic Outlet Syndrome after motor vehicle accidents in a Canadian pain clinic population. Clin J Pain 11:316-324, 1995.

  • Mailis A, Meindok H, Papagapiou M, Pham D. Alterations of the three phase bone scan after sympathectomy. Clin J Pain, 10:146-155, 1994.

  • Mailis A, Wade JA. Clinical profiles of female patients with genetic predisposition to RSD: a pilot study. Clin J Pain 10:210-217, 1994.

  • Mailis A., J. Chan, Basinski A., Feindel C., Vanderlinden G., Taylor A., Flock D., Evans D. Chest wall pain after aortocoronary bypass surgery using internal mammary artery graft: A new pain syndrome? Heart & Lung 18:553-558, 1989.

Contributions

Guideline Development Contributor

Dr. Angela Mailis is a prominent expert in pain management, known for her significant contributions to developing guidelines for opioid prescribing and pain treatment. Her work has shaped evidence-based practices and improved patient care in the field.

SIG Canadian Pain Society Evidence based guidelines for interventional and non interventional neuropathic pain management (2009- 2012) (Co-chair) (Awarded for this the Harold Merskey CPS award)

CPSO Methadone for Pain Guidelines (CPSO 2004) (Committee member) and CPSO Evidence based recommendations for the medical management of chronic non malignant pain (CPSO 2000) (Co-chair)

 

Canadian Pain Guidelines on safe opioid prescribing (2017), Core research group.

IASP Special Interest group on evidence-based recommendations for the treatment of CRPS (2012) 

CPSO/NOUGG Evidence based recommendations for the safe and effective use of opioids for CNCP (primary author and participant) 2007-2010.

SIG Canadian Pain Society Consensus statement and guidelines for Neuropathic Pain Management (2007) (Committee member)

Research Contributions

Pioneering Contributions of Dr. Angela Mailis

Dr. Angela Mailis has made significant contributions to the field of pain management and research through her pioneering work, which has been documented across numerous scientific publications. Her research has illuminated previously unknown aspects of chronic pain, leading to new understandings and treatments. Here’s a brief overview of her key contributions:

1989
In 1989, Dr. Mailis observed a number of patients after triple heart bypass who presented to her with an unusual pain syndrome in their left chest wall, unable to even tolerate their clothes touching the skin. She collected several cases, approached her colleagues in cardiovascular surgery and the team described for the first time the existence of a novel pain syndrome, occurring after using the Internal Mammary (Thoracic) artery to bypass one of the blocked heart vessels (Heart & Lung 18:553-558, 1989). Dr. Mailis and her team followed up with another publication (Ann Thor Surg 69:1455-8, 2000). Ultimately, the syndrome became well known around the world and Mailis’s publications were followed by numerous other research papers by colleagues around the world.
1994
In 1994 Dr. Mailis and her colleague Dr. Wade described for the first time certain genetic abnormalities in a series of female patients with a puzzling condition called Reflex Sympathetic Dystrophy (renamed later Complex Regional Pain Syndrome) (Clin J Pain 10:210-217, 1994). Numerous other studies later by European and other colleagues confirmed the original observations.
1996
In 1996 Dr. Mailis alone presented for the first time in the literature a series of patients who were attacking compulsively their painful limb, a phenomenon similarly observed in animals (Pain 64:569-578, 1996).
1997
In 1997, Dr. Mailis published with her team two studies in humans who received intravenous infusion of the popularly known “truth serum” (sodium Amytal, a medium action barbiturate), for the first time demonstrating the unique effects of the drug in patients with different pain conditions (Pain 70:59-68, 1997a; Pain 70:69-81, 1997b). Dr. Mailis is the world’s most published expert in the use of medium action barbiturates in the diagnosis of chronic pain mechanisms with many more scientific papers on the subject preceding and following these two papers.
2001
In 2001 Dr. Mailis and her team published a seminal paper (J Rheumatol 28:1385-1393, 2001) describing a significant number of chronic pain patients with intractable pain but at the same time they have lost the sensation from the painful limb. They also named these unexplainable loss of sensation “Non Dermatomal Somatosensory Deficits”, for short NDSDs, and speculated these NDSDs are due to “faulty brain wiring”.
2003
In 2003 Dr. Mailis and colleagues published the first functional MRI paper (Neurology 60:1501-1507, 2003), demonstrating changes in brain patterns in patients with NDSD and confirming the concept of “faulty brain wiring”. Subsequent extensive research by the Mailis group and European colleagues confirmed Dr. Mailis’ original observations.
2008
In 2008 Dr. Mailis and team published the only series in the literature (Clin J Pain 2008;24:176–185) of patients who attempted to imitate Complex Regional Pain Syndrome by inflicting injuries to themselves.
2010
In 2010, Dr. Mailis and team published the first (and only so far) study in the literature relating to patient complaints to a pain clinic with specific details of who complains and for what reason (Pain Res Manage 2010, Volume 15 Issue 1: 17- 23).
2019
In 2019, Dr. Mailis and Dr. Lakha published a seminal paper describing the process of translating policies to a unique hybrid model of a community-based pain clinic (funded partially by the Ontario Ministry of Health and partially through privately paid services) (Canadian Journal of Pain, 2019, 3:1, 114- 125), i.e. the current Pain and Wellness Centre directed by Dr. Mailis since its inception in 2014.
2022
In 2022, Dr. Mailis and team published long term outcomes of patients who attended a unique interdisciplinary pain management program in Canada, offering personalized pain services t at the Pain and Wellness Centre funded by the Ontario Ministry of Health (Journal of Patient-Reported Outcomes (2022) 6:44).
Media

In the News

Dr. Angela Mailis is a prominent expert in pain management, known for her significant contributions to developing guidelines for opioid prescribing and pain treatment. Her work has shaped evidence-based practices and improved patient care in the field.

• Toronto Star. Probing Pain. November 1987.
• CITY TV. Chronic Pain, Winter 1987.
• CHFI. Dealing with Chronic Pain, Winter 1987.
• Canadian Living. Chronic Pain, July 1988.
• McLean’s. Chronic Pain, December 1988.
• The back letter. Truth serum. November 1988.
• Science Section, TV Ontario. “All in our heads”. Chronic Pain: Philosophical Concepts and approach. April 1989.
• Multicultural TV and Rogers Cable. Drug abuse in Chronic Pain. November 1990.
• Toronto Sun. Chronic Pain. April 1991.
• Lifebeat, TV Ontario. Chronic Pain. October 23,1991.
• Toronto Star. Easing the Pain. November 21,1991.
• Channel 47. Chronic Pain. Italian Program. January 29, 1992.
• Channel 47. Chronic Pain. Greek Program February 1992.
• CBC. Man Alive, April 1992.
• CBC. Live 5.30. Chronic Pain. April 1, 1993.
• Rogers, Cable 10. Chronic Pain. April 28, 1994.
• CTV, W5. Canada Pension Disability. April 2, 1996.
• CTV. Stats Canada report on Chronic Pain. April 2, 1996.
• CBC Health Show. Post-herpetic neuralgia, January 1999.
• Profile, Toronto Life Magazine, September 1999 issue.
• Featured in Diagnosis MD, Life Network, 9 shows (October 2001- April 2002).
• April – September 2003. Numerous appearances in press, radio and TV (Discovery Channel, CBC radio 1, CTV, Rogers TV Toronto, Rogers TV Ottawa, CIUT, CFRA AM, CFUO AM, CHRO TV, Canadian Living, Dallas Daily, CBC Radio 1 “The culture of Pain”, Canadian Living etc).
• NATIONAL REVIEW OF MEDICINE, Nov 15, 2005, Vol 2, #19, On Physicians’ Life: Easy riding pain specialist Dr Angela Mailis-Gagnon
• Day-in-the-life-of Dr. Angela Mailis By Elissa Rennert, University of Toronto Med Class 201, UofT News
• The STAR February 7, 2014: On the Shingles Vaccine
• TORONTO SUN: OxyContin drug scandal hits Ontario, Nov. 3, 2012
• UHN News: Dr. Mailis goes to Greece with PM Harper May 27-29, 2011
• CTV News Nov 2, 2011
• CBC News Jun 21, 2014
• Vaughan Archives KeyNote Speaker Intern Women’s Day 26 Febr 2015
• Agenda TVO Jan 5, 2016
• Featured in GRIT MAY 4, 2020 A hidden Hurt
• Featured in The Well Woman Show with Giovanna Rossi on NPR’s New Mexico statin KUNM Sept 4, 2019
• Featured in Dr. Wendy Walsh’s podcast on KFI AM640, Los Angeles, Sept. 29, 2019
• CMAJ News Carolyn Brown | Ottawa | November 1, 2018
• Featured in MacLean’s October 2019 issue
• CHML Health & Wellness Show, Sept. 30, 2019, Hamilton ON Global News radio
• Golden West Radio Connections. October 3, 2019. Christian Syndicated program ON, Ab, SK, Man, BC
• Mars Hill Network Mornings October 3, 2019, US Christian Syndicated program
• Feminine Radio Podcast, October 8, 2019, California
• CFAX 1070, October 15, 2019, Bell Media radio, Victoria BC
• PEEL Family Mediation Services (PFMS) Conference, Invited Keynote speaker November 15, 2019
• DARPAN. Great Expectations: Women & Relationships, 20 Nov, 2019
• Managing pain with interdisciplinary Care. On Spinal Chat. OCA podcast. May and September 2023